【摘要】：目的:通過半結(jié)構(gòu)式訪談和問卷調(diào)查探討中青年冠脈支架植入術(shù)后患者自我感受負(fù)擔(dān)的影響因素,為降低患者自我感受負(fù)擔(dān),促進(jìn)疾病恢復(fù),同時也為醫(yī)護(hù)工作者能進(jìn)行針對性的干預(yù)提供參考依據(jù)。方法:本研究分為兩個部分。自2016年3月至2017年1月,選擇在江西省南昌市兩所綜合性三級甲等醫(yī)院心內(nèi)科住院部及門診復(fù)查的中青年冠脈支架植入術(shù)后患者作為研究對象。第一部分,使用質(zhì)性研究現(xiàn)象學(xué)法,制定訪談大綱,對12名患者進(jìn)行半結(jié)構(gòu)式訪問。訪談資料采用Colaizzi分析法進(jìn)行歸納、分析,最后提煉出主題,描述他們由于自身疾病而產(chǎn)生的SPB狀況的體驗(yàn)。第二部分,運(yùn)用一般資料問卷、自我感受負(fù)擔(dān)量表、綜合醫(yī)院焦慮抑郁量表及簡易健康狀況調(diào)查問卷評估153名患者的一般情況、自我感受負(fù)擔(dān)、焦慮抑郁和生活質(zhì)量現(xiàn)狀。采用SPSS17.0統(tǒng)計(jì)軟件對數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,本研究中應(yīng)用的方法有描述性分析、t檢驗(yàn)、單因素方差分析、Pearson相關(guān)性分析及多元線性逐步回歸分析。結(jié)果:第一部分:將質(zhì)性訪談后收集的資料提煉出5個主題:疾病因素,經(jīng)濟(jì)負(fù)擔(dān),心理內(nèi)疚感過重,缺乏疾病相關(guān)康復(fù)知識,未能實(shí)現(xiàn)自我價值。第二部分:問卷調(diào)查結(jié)果中青年冠脈支架植入術(shù)后患者自我感受負(fù)擔(dān)總分為32.15±8.96分。其包含的身體負(fù)擔(dān)、情感負(fù)擔(dān)、經(jīng)濟(jì)負(fù)擔(dān)維度得分分別是5.35±1.90分、19.51±5.58分和7.26±8.96分。其中,一般資料單因素分析顯示,患者的不同年齡段、目前工作狀態(tài)、家庭月收入、支架植入數(shù)目、對病情了解程度及合并癥等對自我感受負(fù)擔(dān)影響有統(tǒng)計(jì)學(xué)意義(P0.05);相關(guān)性分析提示患者自我感受負(fù)擔(dān)與焦慮抑郁呈正相關(guān),與生活質(zhì)量呈負(fù)相關(guān);多元線性逐步回歸分析結(jié)果顯示:生活質(zhì)量、抑郁、目前工作狀態(tài)(繼續(xù)工作)、對疾病了解程度和家庭月收入是中青年冠脈支架植入患者自我感受負(fù)擔(dān)的重要影響因素。結(jié)論:1.中青年冠脈支架植入術(shù)后患者的自我感受負(fù)擔(dān)大部分處于中度及以上程度。2.中青年冠脈支架植入術(shù)后患者的焦慮抑郁發(fā)生率較高,與患者自我感受負(fù)擔(dān)呈正相關(guān);患者的生活質(zhì)量水平較低,與其自我感受負(fù)擔(dān)呈負(fù)相關(guān)。3.患者生活質(zhì)量水平、抑郁狀態(tài)、目前工作狀態(tài)(繼續(xù)工作)、對疾病了解程度和家庭月收入是中青年冠脈支架植入術(shù)后患者自我感受負(fù)擔(dān)的重要影響因素。4.通過質(zhì)性和量性研究相結(jié)合的方法更全面的探討中青年冠脈支架植入術(shù)后患者自我感受負(fù)擔(dān)的影響因素,可以對單一質(zhì)性研究和量性研究的缺點(diǎn)進(jìn)行互補(bǔ)。
[Abstract]:Objective: to explore the influencing factors of the self-feeling burden of young and middle-aged patients after coronary stent implantation through semi-structured interviews and questionnaires, in order to reduce the burden of self-perception and promote the recovery of disease. At the same time, it also provides reference for health care workers to carry out targeted intervention. Methods: this study was divided into two parts. From March 2016 to January 2017, young and middle-aged patients undergoing coronary stent implantation in two comprehensive Grade 3A hospitals in Jiangxi Province were selected as subjects. In the first part, using the phenomenological method of qualitative research, the interview syllabus was developed and 12 patients were interviewed in a semi-structured way. The interview data were summarized and analyzed by Colaizzi method. Finally, the theme was extracted to describe the experience of SPB status caused by their own disease. In the second part, 153 patients were assessed with general information questionnaire, self-perceived burden scale, general hospital anxiety and depression scale and simple health status questionnaire. The methods used in this study are descriptive analysis, t test, single factor variance analysis, Pearson correlation analysis and multiple linear stepwise regression analysis. Results: in the first part, the data collected after qualitative interview were abstracted into five themes: disease factors, economic burden, excessive psychological guilt, lack of rehabilitation knowledge related to disease, and failure to realize self-worth. Part two: the total score of self-feeling burden of young patients after coronary stent implantation was 32.15 鹵8.96. The scores of physical burden, emotional burden and economic burden were 5.35 鹵1.90, 19.51 鹵5.58 and 7.26 鹵8.96 respectively. Single factor analysis of general data showed that the patients' different age, current working status, family monthly income, the number of stent implantation, the degree of understanding of the disease and complications had a significant impact on the burden of self-perception (P0.05). Correlation analysis showed that the self-perceived burden was positively correlated with anxiety and depression, and negatively correlated with quality of life. The results of multiple linear stepwise regression analysis showed that quality of life, depression, current working status, understanding degree of disease and monthly income of family were the important factors influencing self-feeling burden of young and middle-aged patients with coronary stent implantation. Conclusion: 1. The burden of self-perception of young and middle-aged patients after coronary stent implantation was mostly in the moderate and above degree. 2. 2. The incidence of anxiety and depression was higher in young and middle-aged patients after coronary stent implantation, which was positively correlated with the burden of self-feeling, and the quality of life was lower, which was negatively correlated with the burden of self-perception. The quality of life (QOL), depression, current working status (continue to work), the degree of understanding of disease and monthly family income are the important factors that affect the burden of self-feeling after coronary stent implantation in young and middle-aged patients. 4. Through the combination of qualitative and quantitative studies, the factors affecting the self-perception burden of young and middle-aged patients after coronary stent implantation are discussed more comprehensively, which can complement the shortcomings of single qualitative research and quantitative research.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.5

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